Secondary Spontaneous Pneumothorax in a COVID-19 Recovered Patient

Sahagun, Joseph; Chopra, Amit; David, Alan G; Dao, David; Chittivelu, Subramanyam

doi:10.7759/cureus.16415

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…On a cellular level, the changes of the parenchyma secondary to COVID-19 can play a role. For instance, the disruption of protein, downregulation of surfactant, loss of extracellular matrix and surfactant and hypercoagulative state can all contribute to developing pneumothorax in COVID-19 patients (7). In the present cases, we found that the presence of pneumothorax in patients with COVID-19 pneumonia can be present at any time of admission whether they were mechanically ventilated or not.…”

Section: Discussionsupporting

confidence: 52%

COVID-19 Patients with Tension Pneumothorax: Four Case Reports

Alsulaim¹,

Sobh²,

Alodhaybi³

et al. 2022

JOHS

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Severe acute respiratory syndrome Corona virus 2 (SARS-CoV 2) was initially identified in December 2019 in Wuhan, China. The coronavirus disease (COVID-19) spread rapidly worldwide to become a global pandemic. Patients infected with this virus presented with fever, cough, shortness of breath, diarrhea, abdominal discomfort, and myalgia. Radiological examination of those patients revealed numerous findings like consolidation, ground glass opacity and can lead to lung collapse. Other uncommon features are presented such as pneumomediastinum, pneumothorax and lung cavity. Pneumothorax was one of the fatal complications mentioned in the literature as it increased the mortality of COVID-19 patients. We report four cases presented to the intensive care unit (ICU) with severe pneumonia complicated during the admission by pneumothorax, which mandated intervention by chest tube to stabilize the patient's condition. There were differences in age, sex, the treatment protocol used and the timing of the development of the pneumothorax. Pneumothorax should be kept in mind in patients admitted with pneumonia secondary to COVID-19, as it causes acute deterioration of the patient and needs urgent intervention.

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Section: Discussionsupporting

confidence: 52%

COVID-19 Patients with Tension Pneumothorax: Four Case Reports

Alsulaim¹,

Sobh²,

Alodhaybi³

et al. 2022

JOHS

View full text Add to dashboard Cite

show abstract

“…Pneumothorax and pneumomediastinum were observed predominantly in our patient who had history of critical COVID-19. It was found that pneumothorax can occur in any phase of the disease and even as a late sequela after recovery from initial infection in the absence of prior pulmonary disease or barotrauma [30,31].…”

mentioning

confidence: 99%

Post COVID-19 sequelae of the respiratory system. A single center experience reporting the compromise of the airway, alveolar and vascular components

Iqbal

Khanum²,

Kazi³

et al. 2022

Monaldi Arch Chest Dis

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The long-term sequelae of COVID-19 have now become more common and appreciable. The SARS-CoV-2 virus can cause a variety of infectious and non-infectious pulmonary complications. The purpose of this study is to raise awareness about post-COVID-19 pulmonary sequelae, both infectious and non-infectious, in this geographical area. A retrospective study was conducted from July 1st 2020 to December 20th 2020. A total of 1200 patients were evaluated, with 83 suffering from post-COVID-19 pulmonary complications. The patients' mean age was 62 years (IQR 55-69), with 63 (75.9%) being male. The most common co-morbid illnesses were hypertension (49, 59%) and diabetes (45, 54.2%). The majority of them (37, 44.6%) had severe COVID-19, followed by critical COVID-19 (33, 39.8%). There was no statistically significant difference in recurrence of respiratory symptoms or duration of current illness between non-severe, severe, and critical COVID-19 patients. Non-infectious complications were observed in the majority of patients (n=76, 91.5%), including organizing pneumonia/ground glass opacities in 71 (88%) patients, fibrosis in 44 (55%), pulmonary embolism in 10 (12.5%), pneumomediastinum in 6 (7.4%) and pneumothorax in 7 (8.6%). Infective complications (25, 30.1%) included aspergillus infection in 10 (12.0%) and bacterial infection in 5 (8.47%), with more gram-negative infections and one patient developing Mycobacterium tuberculosis. Post COVID-19 mortality was 11 (13.3%). The long-term pulmonary sequelae of COVID-19 are not rare. Cryptogenic organizing pneumonia, ground glass opacities, and fibrosis were common post-COVID-19 sequelae in our patients. This necessitates frequent close monitoring of these patients in order to initiate early appropriate management and prevent further morbidity and eventual mortality.

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“…One study indicated that 7.4% of post-COVID-19 patients develop pneumomediastinum, and 8.6% develop pneumothorax. [7] Although many case reports cite an increase in the rate of pneumothorax in post-COVID-19 patients, [8][9][10] data on this finding after cardiac surgery are limited. In their study evaluating the effect of COVID-19 infection on cardiac surgery outcomes, Thomas et al [5] evaluated preoperative chest computed tomography (CT) findings and detected emphysematous and fibrotic changes in 2.85% and 42.8% of patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

Effect of Previous Coronavirus Disease 2019 Infection on Patients Undergoing Open-Heart Surgery

Girgin

2023

GKDA Derg

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Objectives: This study aimed to evaluate the effects of previous coronavirus disease 2019 infection on mortality, factors influencing mortality, and potential postoperative complications in on-pump cardiac surgery. Methods: This single-center, retrospective, observational study included 233 adult patients who underwent on-pump cardiac surgery between June 2021 and February 2022. Patients with preoperative history of COVID-19 infection confirmed by nasopharyngeal swab polymerase chain reaction (PCR) test were compared to those without COVID-19 history. Results: Patients' mean age was 60.12±11.26 years (range, 23-81 years), and 77.3% were male. The mean time from PCR positivity to surgery was 191.11±169.9 days (median, 108 days). No between-group differences were observed in anesthesia, cross-clamp time, pump time, operative time, extubation time, length of intensive care unit and hospital stay, or mortality (p>0.05). The post-COVID-19 group had higher rates of preoperative acute neurologic events and arrhythmias, pump lactate levels, and intraoperative inotropic scores (p<0.05). These factors were not associated with survival. Postoperative pneumothorax was more frequent in the post-COVID-19 group (p=0.002) and associated with longer length of hospital stay. No significant difference was observed in preoperative, postoperative, or changes in neutrophil/lymphocyte ratio (NLR) between groups. Conclusion:Patients with and without COVID-19 history had similar outcomes after open-heart surgery. Nevertheless, the former had increased frequency of postoperative pneumothorax and prolonged length of hospital stay. Open-heart surgery seems safe after COVID-19. However, larger, prospective studies including inflammatory markers other than NLR are needed to further investigate the potential complications.

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Secondary Spontaneous Pneumothorax in a COVID-19 Recovered Patient

Cited by 4 publications

References 20 publications

COVID-19 Patients with Tension Pneumothorax: Four Case Reports

COVID-19 Patients with Tension Pneumothorax: Four Case Reports

Post COVID-19 sequelae of the respiratory system. A single center experience reporting the compromise of the airway, alveolar and vascular components

Effect of Previous Coronavirus Disease 2019 Infection on Patients Undergoing Open-Heart Surgery

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